<%@page contentType="text/html" language="java" pageEncoding="UTF-8"%>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">

<table align=center border=0 style='color:#800000;'>
<tr align=right>
 <td>Business Name: <input type=text maxlength=72 size=24 name="Your Business Name"/></td>
 <td width=30>&nbsp;</td>
 <td>Your Name: <input type=text maxlength=72 size=24 name="Your Name"></td>
</tr>
<tr align=right>
 <td>Your Phone: <input type=text maxlength=72 size=24 name="Your Phone Number"/></td>
 <td width=30>&nbsp;</td>
 <td>Your e-mail: <input type=text maxlength=72 size=24 name="Your e-mail"/></td>
</tr>
</table><br/>
<b>1</b>
<table border=0 style="font-size:7.25pt;" bgcolor=#EAF2EA>
<tr height=20><th>Brand Name</th><th>Manufacture Part Number</th><th>Model Number</th><th>Condition</th>
 <th>Quantity</th><th>Target Price(ea.)</th><th>Substitute</th><th>Time to Search</th>
</tr>
<tr height=20 align=center>
 <td><input type=text maxlength=72 size=21 name="1Brand Name"/></td>
 <td><input type=text maxlength=72 size=21 name="1Manufacture Part Number"/></td>
 <td><input type=text maxlength=72 size=31 name="1Model Number"/></td>
 <td>
 <select name="1Condition">
  <option/>Any
  <option/>New
  <option/>Refurbished
  <option/>Used
 </select>
 </td>
 <td><input type=text maxlength=72 size=6 name="1Quantity"/></td>
 <td><input type=text maxlength=72 size=12 name="1Target Price(ea.)"/></td>
 <td>
 <select name="1Substitute">
  <option/>Yes&nbsp;&nbsp;&nbsp;
  <option/>No
 </select>
 </td>
 <td>
 <select name="1Time to Search">
  <option/>Urgent
  <option/>1-2 days
  <option/>3-4 days
  <option/>Week
  <option/>Two Weeks
 </select>
 </td>
</tr>
<tr>
 <td colspan=8>
  <table border=0>
    <tr>
    <td><textarea cols=58 rows=2 name="1Description">Description:</textarea></td>
    <td><textarea cols=58 rows=2 name="1Comments">Comments:</textarea></td>
    </tr>
  </table>
 </td>
</tr>
</table>
<br/>
<b>2</b>
<table border=0 style="font-size:7.25pt;" bgcolor=#EAF2EA>
<tr height=20>
 <th>Brand Name</th><th>Manufacture Part Number</th><th>Model Number</th><th>Condition</th>
 <th>Quantity</th><th>Target Price(ea.)</th><th>Substitute</th><th>Time to Search</th>
</tr>
<tr height=20 align=center>
 <td><input type=text maxlength=72 size=21 name="2Brand Name"/></td>
 <td><input type=text maxlength=72 size=21 name="2Manufacture Part Number"/></td>
 <td><input type=text maxlength=72 size=31 name="2Model Number"/></td>
 <td>
 <select name="2Condition">
  <option/>Any
  <option/>New
  <option/>Refurbished
  <option/>Used
 </select>
 </td>
 <td><input type=text maxlength=72 size=6 name="2Quantity"/></td>
 <td><input type=text maxlength=72 size=12 name="2Target Price(ea.)"/></td>
 <td>
 <select name="2Substitute">
  <option/>Yes&nbsp;&nbsp;&nbsp;
  <option/>No
 </select>
 </td>
 <td><select name="2Time to Search">
  <option/>Urgent
  <option/>1-2 days
  <option/>3-4 days
  <option/>Week
  <option/>Two Weeks
 </select>
 </td>
</tr>
<tr>
<td colspan=8>
 <table border=0>
  <tr>
  <td><textarea cols=58 rows=2 name="2Description">Description:</textarea></td>
  <td><textarea cols=58 rows=2 name="2Comments">Comments:</textarea></td>
  </tr>
 </table>
</td>
</tr>
</table>
<br/>
